The surgical management of metastatic pancreatic acinar cell carcinoma and associated pancreatic panniculitis-A case report and literature review.

International Journal of Surgery Case Reports
Edward M ClarkeGraham Starkey

Abstract

Pancreatic panniculitis is a rare manifestation of benign and malignant pancreatic disease. The presentation of pancreatic panniculitis is non-specific and thus diagnosis is often delayed. When associated with malignancy, pancreatic panniculitis confers a poor prognosis. This case demonstrates the successful surgical management of this paraneoplastic phenomenon following resection of the underlying pancreatic acinar cell carcinoma and associated liver metastasis. A 71-year-old female with debilitating subcutaneous lower limb lesions had a delayed diagnosis of pancreatic panniculitis. A formal diagnosis of pancreatic acinar cell carcinoma with liver metastasis was established and the disease was determined to be resectable. Pre-operatively, serum lipase measured 10,825 U/L. The patient proceeded to an open left hemihepatectomy and radical distal pancreatectomy with complete resection of malignant disease. Six days post-operatively the serum lipase levels normalised, and the panniculitis began to settle. The patient proceeded to adjuvant FOLFORINOX chemotherapy. Twenty months post-surgery, the patient remains disease-free and without any evidence of panniculitis. Due to the rarity of pancreatic acinar cell carcinoma, guidelines b...Continue Reading

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Citations

May 24, 2021·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·Vishwajith SridharanYasmin G Hernandez-Barco

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Methods Mentioned

BETA
surgical resection
biopsy
hysterectomy
hormone replacement
ESR
pancreatectomy

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